
<!DOCTYPE html>
<html lang="en">
<head>
<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1" />
<meta charset="utf-8" />
<title>Blank Page - Ace Admin</title> [#include
"/admin/common/commonurl.html"]
<link rel="stylesheet"
	href="${siteurl}assets/plugs/tagsinput/jquery.tagsinput.css">

</head>

<body class="no-skin">
	<div id="navbar" class="navbar navbar-default">
		<script type="text/javascript">
			try {
				ace.settings.check('navbar', 'fixed')
			} catch (e) {
			}
		</script>

		[#include "/admin/common/navbar.html"]

		<!-- /.navbar-container -->
	</div>

	<div class="main-container" id="main-container">
		<script type="text/javascript">
			try {
				ace.settings.check('main-container', 'fixed')
			} catch (e) {
			}
		</script>

		<div id="sidebar" class="sidebar                  responsive">
			<script type="text/javascript">
				try {
					ace.settings.check('sidebar', 'fixed')
				} catch (e) {
				}
			</script>
			[#include "/admin/common/shortcuts.html"]
			<!-- /.sidebar-shortcuts -->

			<!-- .nav-list -->
			[#include "/admin/common/commonmenu.html"]
			<ul class="nav nav-list">[@menustag id=1] [#list list as item]
				[@menu item "1,46"] [/@menu] [/#list] [/@menustag]
			</ul>
			<!-- /.nav-list -->

			<div class="sidebar-toggle sidebar-collapse" id="sidebar-collapse">
				<i class="ace-icon fa fa-angle-double-left"
					data-icon1="ace-icon fa fa-angle-double-left"
					data-icon2="ace-icon fa fa-angle-double-right"></i>
			</div>

			<script type="text/javascript">
				try {
					ace.settings.check('sidebar', 'collapsed')
				} catch (e) {
				}

				function updatering() {
					$("#processinfos").slideDown();
					$.get("${siteurl}ring/downring.htm", function() {
						$("#processinfos").slideUp();
					});
				}
			</script>
		</div>

		<div class="main-content">
			<div class="breadcrumbs" id="breadcrumbs">
				<script type="text/javascript">
					try {
						ace.settings.check('breadcrumbs', 'fixed')
					} catch (e) {
					}
				</script>

				<ul class="breadcrumb">
					<li><i class="ace-icon fa fa-home home-icon"></i> <a href="#">首页</a>
					</li>

					<li class="active">添加用户</li>
				</ul>
				<!-- /.breadcrumb -->

				<div class="nav-search" id="nav-search">
					<form class="form-search">
						<span class="input-icon"> <input type="text"
							placeholder="Search ..." class="nav-search-input"
							id="nav-search-input" autocomplete="off" /> <i
							class="ace-icon fa fa-search nav-search-icon"></i>
						</span>
					</form>
				</div>
				<!-- /.nav-search -->
			</div>



			<div class="page-content">
				[#include "/admin/common/page.html"] [#include
				"/admin/common/settings.html"]
				<div class="row">
					<div class="col-xs-12">

						<form role="form" method="post" class="form-horizontal"
							action="${siteurl}admin/xaioerbaike/model_add.htm">

							<div class="form-group">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 名称</label>

								<div class="col-sm-9">
									<input type="text" name="name" class="col-xs-10 col-sm-10"
										placeholder="体系名称" id="form-field-1">
								</div>
							</div>
							<div class="form-group">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 别名</label>

								<div class="col-sm-9">
									<input id="cname" type="text" name="cname" class="col-xs-10 col-sm-10"
										placeholder="别名" id="form-field-1">
								</div>
							</div>
							<div class="form-group">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 部位</label>

								<div class="col-sm-9">
									<select name="typeinfo" class="col-xs-10 col-sm-10">
										<option>全身</option>
										<option>头部</option>
										<option>皮肤</option>
										<option>咽喉</option>
										<option>肛门</option>
										<option>五脏</option>
										<option>呼吸</option>
										<option>肢体行为</option>
										<option>骨</option>
										<option>其他</option>
									</select>
								</div>
							</div>
							<div class="form-group">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 挂号科室</label>

								<div class="col-sm-9">
									<input id="guahaokeshi" type="text" name="guahaokeshi"
										class="col-xs-10 col-sm-10" placeholder="挂号科室"
										id="form-field-1">
								</div>
							</div>
							<div class="form-group">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 费用</label>

								<div class="col-sm-9">
									<input type="text" name="feiyong" class="col-xs-10 col-sm-10"
										placeholder="费用" id="form-field-1">
								</div>
							</div>
							<div class="form-group">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 医保</label>

								<div class="col-sm-9">
									<select name="yibao" class="col-xs-10 col-sm-10">
										<option>支持</option>
										<option>不支持</option>
										<option>不清楚</option>
									</select>
								</div>
							</div>
							<div class="form-group">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 症状</label>

								<div class="col-sm-9">
									<input id="zhengzhuang" type="text" name="zhengzhuang"
										class="col-xs-10 col-sm-10" placeholder="症状"
										id="form-field-1">
								</div>
							</div>
							<div class="form-group">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 治疗</label>

								<div class="col-sm-9">
									<input type="text" name="ziliang" class="col-xs-10 col-sm-10"
										placeholder=" 描述" id="form-field-1">
								</div>
							</div>
							<div class="form-group" style="display: none;">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 病因</label>

								<div class="col-sm-9">
									<input type="text" name="binying" class="col-xs-10 col-sm-10"
										placeholder=" 描述" id="form-field-1">
								</div>
							</div>
							<div class="form-group">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 常用药物</label>

								<div class="col-sm-9">
									<input id="changyongyuewu" type="text" name="changyongyuewu"
										class="col-xs-10 col-sm-10" placeholder=" 描述"
										id="form-field-1">
								</div>
							</div>
							<div class="form-group" style="display: none;">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 疾病自测</label>

								<div class="col-sm-9">
									<input type="text" name="jibinzice" class="col-xs-10 col-sm-10"
										placeholder=" 描述" id="form-field-1">
								</div>
							</div>
							<div class="form-group" style="display: none;">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 项目检查</label>

								<div class="col-sm-9">
									<input type="text" name="xiangmujiancha"
										class="col-xs-10 col-sm-10" placeholder=" 描述"
										id="form-field-1">
								</div>
							</div>
							<div class="form-group">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 疾病详情</label>

								<div class="col-sm-9">
									<textarea rows="8" type="text" name="demo1" class="col-xs-10 col-sm-10"
										placeholder=" 疾病详情" id="form-field-1"></textarea>
								</div>
							</div>
							<div class="form-group">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 常用药物</label>

								<div class="col-sm-9">
									<input type="text" name="demo2" class="col-xs-10 col-sm-10"
										placeholder=" 常用药物" id="form-field-1">
								</div>
							</div>
							<div class="form-group">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 预防</label>

								<div class="col-sm-9">
									<textarea rows="8" type="text"  name="demo3" class="col-xs-10 col-sm-10"
										placeholder=" 预防" id="form-field-1"></textarea>
								</div>
							</div>
							<div class="form-group" style="display: none;">
								<label for="form-field-1"
									class="col-sm-3 control-label no-padding-right"> 治疗率</label>

								<div class="col-sm-9">
									<input type="text" name="demo4" class="col-xs-10 col-sm-10"
										placeholder=" 治疗率" id="form-field-1">
								</div>
							</div>









							<div class="clearfix form-actions">
								<div class="col-md-offset-3 col-md-9">
									<button type="submit" class="btn btn-info">
										<i class="ace-icon fa fa-check bigger-110"></i> 保存
									</button>

									&nbsp; &nbsp; &nbsp;
									<button type="reset" class="btn">
										<i class="ace-icon fa fa-undo bigger-110"></i> 重置
									</button>
								</div>
							</div>

							<div class="hr hr-24"></div>




						</form>


					</div>
				</div>


			</div>
		</div>
		<!-- /.main-content -->

		[#include "/admin/common/footer.html"]

	</div>
	<!-- /.main-container -->

	<!-- basic scripts -->

	[#include "/admin/common/scripts.html"]
	<script type="text/javascript"
		src="${siteurl}assets/plugs/tagsinput/jquery.tagsinput.js"></script>

	<!-- inline scripts related to this page -->
	<script type="text/javascript">
		$(document).ready(function() {
			$('#zhengzhuang').tagsInput({
				height : '20',width:'577',defaultText:"添加症状"
			});
			$('#cname').tagsInput({
				height : '20',width:'577',defaultText:"添加别名"
			});
			$('#changyongyuewu').tagsInput({
				height : '20',width:'577',defaultText:"常用药物"
			});
			$('#guahaokeshi').tagsInput({
				height : '20',width:'577',defaultText:"挂号科室"
			});	
			
		});
	</script>
</body>
</html>
